Nopal (also known as prickly pear) has been used as both food and medicine. Nopals are common in North American deserts and are generally sold fresh, canned, or dried for use in the preparation of traditional Mexican dishes. Nopal juice is used in jellies and candies. The fruit is also eaten fresh or used in pies, deserts, shakes, or spreads.

Traditionally, nopal has been used as an anti-inflammatory or a laxative. Nopal may offer benefits to individuals with an alcohol-induced hangover, diabetes, or hyperlipidemia (high cholesterol). However, additional research is needed.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Some studies suggest that nopal may prevent hangover symptoms, including fatigue, headache, dizziness, and a general unpleasant feeling. More evidence is needed before a conclusion can be made.

C

Scientific studies suggest that nopal may reduce blood glucose levels in people with type 2 diabetes. More research is needed before conclusions can be made.

C

Some studies have found that nopal may help reduce cholesterol. However, more evidence is needed before conclusions can be made.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Nopal has been taken by mouth as capsules, flowers, dried flower liquid extract, pear pulp, stem extract, broiled and blended stems, broiled leaves, and as the products OpunDiaT and NeOpuntia®.

For hangover prevention, 1,600 international units of nopal have been taken by mouth five hours before drinking alcohol.

For diabetes, the following have been taken by mouth: 10.1 grams of nopal stem extract as a single load, following a glucose load; up to 500 grams of broiled and blended nopal stems as a single dose; a single dose of 30 nopal capsules; 10 nopal capsules three times daily for one week; 100 grams of broiled nopal leaves daily for 10 days; and 400 milligrams of OpunDiaT daily for 16 weeks.

For high cholesterol, the following have been taken by mouth: 1.6 grams of NeOpuntia® three times daily with meals for six weeks; 100 grams of broiled nopal leaves daily for 10 days; 250 grams of edible nopal pulp daily for 4 weeks and 8 weeks; and 10 capsules of nopal three times daily for one week.

Children (younger than 18 years)

There is no proven effective dose for nopal in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to nopal or any of its parts. Nasal inflammation or asthma has been reported due to allergy.

Side Effects and Warnings

Nopal is likely safe when used in food amounts and is common in Mexican and southwestern American cuisine.

Nopal may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Nopal may cause low blood pressure. Caution is advised in people with low blood pressure or in those taking drugs or herbs and supplements that lower blood pressure.

Nopal may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in people who have thyroid dysfunction, impaired liver function, or immune disorders or in those who are taking agents that suppress the immune system or lower cholesterol.

Avoid in individuals with a known allergy or hypersensitivity to nopal or any of its parts.

The nopal plant should be handled carefully, as it is covered in long, sharp spines that may be painful and difficult to remove once embedded in the skin.

Pregnancy and Breastfeeding

There is currently a lack of scientific evidence on the use of nopal during pregnancy or breastfeeding.

Nopal may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Nopal may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Nopal may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Nopal may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Nopal may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Nopal may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

Nopal may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.

Nopal may also interact with antiallergy herbs and supplements, antibacterials, anticancer herbs and supplements, antihistamines, anti-inflammatory herbs and supplements, antioxidants, antiulcer and gastric acid-reducing agents, antivirals, diuretics, fat-soluble vitamins, herbs and supplements that may affect the liver, herbs and supplements that may affect cholesterol levels, herbs and supplements that may affect the immune system, herbs and supplements that may lower seizure threshold, herbs and supplements that may prevent muscle spasms, herbs and supplements that may affect the heart, herbs and supplements that may affect the brain or nervous system, thyroid agents, vitamin C, vitamin E, and weight loss herbs and supplements.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.